| Objective: To investigate the relationship between preoperative immune inflammation index / albumin ratio(SII/ALB)and prognosis of patients with non-small cell lung cancer(NSCLC),and to analyze the prognostic value of SII/ALB in patients with NSCLC.Methods: From January 2015 to June 2016,196 patients with NSCLC who underwent surgical treatment in Hebei Provincial people’s Hospital were selected as the subjects of the study.All patients were confirmed to be NSCLC,by postoperative pathology and fasting venous blood was collected from Hebei Provincial people’s Hospital one week before surgical treatment.The clinical data and related hematological parameters of the subjects were collected and followed up on a monthly basis.The disease-free survival(DFS)and overall survival(OS)were recorded and analyzed by SPSS 23.0 statistical software.Determination of the cut-off point of SII/ALB by drawing the Receiver Operating Characteristic(ROC)curve of the working characteristics of the subjects,according to the optimal cut-off point,the subjects were divided into high and low level SII/ALB groups,and the relationship between them and the collected clinical variables was analyzed.Drawing Survival Curve by Kaplan-Meier method,Log-rank comparison between groups,the regression model of COX proportional risk was analyzed by univariate and multivariate analysis,and the difference was statistically significant(P<0.05).Results:1 The differences in lactate dehydrogenase,platelet count,neutrophils count,and lymphocyte count between high and low SII/ALB levels and those of operable NSCLC patients were statistically significant.(P<0.05).2 The average DFS of low SII/ALB group was 31.713 months,and that of high SII/ALB group was 21.128 months.The average OS of low SII/ALB group was 58.632 months,and that of high SII/ALB group was46.137 months.The average DFS and OS in low SII/ALB group were better than those in high SII/ALB group(P<0.05).3 COX univariate analysis showed that lactic dehydrogenase,albumin,platelet,neutrophil,lymphocytes count and SII/ ALB value were statistically significant in predicting DFS in patients with NSCLC(P<0.05).Multivariate analysis showed platelet count(HR:0.541,95%CI:0.340-0.779;P=0.002),neutrophil count(HR:0.358,95%CI:0.240-0.535;P=0.000),lymphocytes count(HR:2.625,95%CI:1.767-3.900;P=0.000)and lactic dehydrogenase(HR:0.569,95%CI:0.367-0.882;P=0.012)and SII/ALB(HR:0.435,95%CI:0.266-0.711;P=0.001)were independent risk factors for DFS in patients with NSCLC.Albumin,lactic dehydrogenase,platelet,neutrophil,lymphocytes count and SII/ ALB value were statistically significant in predicting OS in patients with NSCLC(P<0.05).Multivariate analysis showed platelet count(HR:0.533,95%CI:0.353-0.803;P=0.003),neutrophil count(HR:0.350,95%CI:0.234-0.522;P=0.000),lymphocytes count(HR:2.267,95%CI:1.513-3.357;P=0.000)and lactic dehydrogenase(HR:0.580,95%CI:0.370-0.908;P=0.017)and SII/ALB(HR:0.538,95%CI:0.329-0.879;P=0.013)were independent risk factors for OS in patients with NSCLC.4 ROC curve was used to compare area under curve(AUC)of statistically significant related hematological indexes in COX multivariate analysis.The maximum AUC of the SII/ALB value is0.866(95%CI:0.815-0.916),which indicated that SII/ALB value was more valuable than other indexes in predicting the prognosis of NSCLC.Conclusion:1 High preoperative SII/ALB levels suggest poor prognosis in patients with operable NSCLC,and have better prognostic value than other indicators in predicting the prognosis of operable NSCLC.2 Preoperative lactate dehydrogenase,platelet,lymphocyte,neutrophil count and SII/ALB value are independent risk factors for DFS and OS in patients with operable NSCLC. |
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